PHILIPPINE CANINE CLUB, INC.

OFFICIAL ENTRY FORM

Club: _________________________________
Date of Show: __________________________

IMPORTANT – Read Carefully Instructions on Reverse Side before Before Filling Out. Numbers in the boxes
indicate sections of the instructions relevant to the information need in that box (PLEASE PRINT)

BREED 5 VARIETY 1 SEX

Reg Name of Dog

Dog Reg. No Date of Birth:(YY/MM/DD) Country

ILP No

Sire Name Sire Reg No

Dam Name Dam Reg No

Breeder(s)

Owner(s) 4:

CONFORMATION SHOW CLASSES 2,3

NON-CACIB CLASSES CACIB CLASSES

Baby Puppy (3 to under 6 months) Intermediate (15 to under 24 months)

Minor Puppy (6 to under 9 months) Open (24 months to under 8 years old)

Puppy (9 to under 12 months) Champion (15 months to under 8 years old)

Junior (12 to under 15 months)

Veterans (8 years old and over)

COMPANION EVENTS
OBEDIENCE TRIALS AGILITY

Novice Open CDX Agility 1 Agility 2 Agility 3

CDG Champion UD Jumping 1 Jumping 2 Jumping 3

OWNER’S CERTIFICATION
I(WE) CERTIFY that I(WE) am/are the actual owner(s) of the dog or that I am the duly authorized agent of the
actual owner(s) whose name(s) I have entered above in consideration of the acceptance of the entry. I (WE)
agree to abide by the rules and regulations of the Philippine Canine Club Inc in effect at the time of this event
and by any additional rules and regulations in the premium list for this event, and further agree to be bound by the
‘ AGREEMENT’ printed on the reverse side of the entry form. I (WE) certify and represent that the dog entered is
not a hazard to persons or other dogs. This entry is submitted for acceptance on the foregoing representation
and AGREEMENT. I (WE) agree to conduct myself (ourselves) in accordance with all such Rules and
Regulations and the provisions of the Bylaws of the Philippine Canine Club Inc and to abide by any decisions
made in accord with them.

SIGNATURE of owner or
his/her/their agent duly authorized ____ /_____ /_____
to make this entry DATE SIGNED

JR/Provisional Form/12/11
 AGREEMENT
I (We) agree that the Club currently holding this event has the exclusive right to refuse this entry for cause
which the Club shall deem sufficient upon its discretion. In consideration of the acceptance of this entry
and of the holding of this event and for the opportunity to have the dog judged and to be qualified to win
prizes, ribbons, or trophies, I (We) agree to hold The Philippine Canine Club, Inc., (”PCCI”) the Club, its
members, directors, governors, officers, agents, superintendents or event secretary and the owner and/or
lessor of the premises and any provider of services that are usually necessary to hold this event and any
employees or volunteers of the aforementioned parties, and any PCCI approved judge, judging at the
event, free and harmless from any claim for loss or injury which may be alleged to have been caused
directly or indirectly to any person or thing by the act of this dog while in or about the event premises or
grounds or near any entrance thereto, and I (We) personally and exclusively assume all responsibility and
liability for any such claim; and I (We) further agree to hold the aforementioned parties harmless from any
claim for loss, injury or damage to this dog.

In addition, I (We) hereby assume the sole and exclusive responsibility for and agree to indemnify, defend
and save the aforementioned parties free and harmless from any and all loss, damages and expense
(including but not limited to legal fees) by reason of the liability imposed by law, rules, regulations and/or
from any judgment, decision and order upon any of the aforementioned parties for loss, damages and
expense because of the bodily injuries, including death at any time that may result therefrom, or as may be
sustained by any person or persons, including myself (ourselves), or also on account of any damage to
property, that may arise out of or in consequence of my (our) participation in this event, however such,
injuries, death or property damage may be caused, and whether or not the same may have been caused
or may be alleged to have been caused by the negligence of the aforementioned parties or any of their
employees, agents, or any other persons. FINALLY I(We) AGREE THAT ANY CAUSE/S OF ACTION,
CONTROVERSY OR CLAIM ARISING OUT OF OR RELATED TO THE ENTRY, EXHIBITION OR
ATTENDANCE AT THE EVENT BETWEEN THE PCCI AND THE EVENT-GIVING CLUB (UNLESS
OTHERWISE STATED IN ITS PREMIUM LIST) AND MYSELF (OURSELVES) OR AS TO THE
CONSTRUCTION, INTERPRETATION AND EFFECT OF THIS AGREEMENT SHALL BE SETTLED
BY ARBITRATION PURSUANT TO APPLICABLE RULES. IT IS ONLY AFTER OF ARBITRATION
BETWEEN THE PARTIES, THAT THEY MAY ELEVATE THE SAME TO THE REGULAR COURTS OF
QUEZON CITY. HOWEVER, PRIOR TO ARBITRATION STAGE, ALL APPLICABLE PCCI BY-LAWS,
RULES, REGULATIONS AND PROCEDURES MUST FIRST BE FOLLOWED AND UTILIZED.
INSTRUCTIONS
1. (Variety) if you are entering a dog of a breed in which there are varieties for show purposes, please
designate the particular variety you are entering, i.e., Cocker Spaniel (solid color black, ASCOB, parti-
color), Dachshunds (standard, miniature, rabbit / longhaired, smooth, wirehaired), Collies (rough, smooth),
Bull Terriers (colored, white), Manchester Terriers (standard, toy), Chihuahuas (smooth coat, long coat),
English Toy Spaniels (King Charles and Ruby, Blenheim and Prince Charles), Poodles (toy, miniature,
standard).
2. The following categories of dogs may be entered and shown in Best of Breed competition: Regular
Class Winners (Winners Dog and Winners Bitch), Winner of Champions of Record Class (Male and
Female), Winner of Veterans Class (Male and Female).
3. (Event Class) Consult the classification in this premium list. If the event class in which you are entering
your dog is divided then, in addition to designating the class, specify the particular division of the class in
which you are entering your dog, i.e, age division, color division, weight division, Philippine Bred.
4. A dog must be entered in the name of the person who actually owned it at the time entries for an event
closed. If a registered dog has been acquired by a new owner it must be entered in the name of its new
owner in any event for which entries closed after the date of acquirement, regardless of whether the new
owner has received the registration certificate indicating that the dog is recorded in his/her name. State on
entry form whether transfer application has been mailed to the PCCI.
5. Mixed Breed dogs entering classes for Agility, Obedience, Rally trials and Flyball should mark Breed as
“Mixed Breed.” Sire and Dam information shall remain blank for mixed breed entrants.

JR/Provisional Form/12/11